Comparison of the Combination of Dexmedetomidine and Midazolam with Dexmedetomidinea Alone in Sedation during Spinal Anesthesia

  • Ling Li
Keywords: Dexmedetomidine, Midazolam, Spinal Anesthesia, Sedation

Abstract

Objective: Our objective is to compare the efficacy and safety of the combination of dexmedetomidine and
midazolam with dexmedetomidine alone in the sedation during spinal anesthesia. Methods: 180 patients admitted
in our hospital between April, 2015-April, 2017 were included and divided into the observation group and control
group for prospective controlled analysis. There were 90 cases in either group. The patients in the observation
group received intravenous injection of dexmedetomidine and midazolam before disinfection, and the patients in
the control group only received intravenous injection of dexmedetomidine. The changes of onset time of sensory
and motor block, hemodynamics changes during anesthesia, Observer’s assessment of alertness/sedation scale
(OAA/S) score, anxiety visual analogue/anxiety questionnaire (AVA/SAI) score and brain bispectral index (BIS)
were compared, the anesthetic adverse reactions were compared and the efficacy and safety of two regimens were
compared. Results: The onset time of sensory block reaching the highest plane and the onset time of motor block
reaching Grade 3 in the observation group were shorter than the control group, which were statistically significant
(P<0.05). The heart rate in the observation group decreased more obviously than the control group at 5-10 min
after drug administration, which was statistically significant (P<0.05). OAA/S score, AVA/SAI score and BIS in
the observation group were lower than the control group at 5-10 min after drug administration, which were
statistically significant (P<0.05). The adverse reaction rate during anesthesia in the observation group was 3.33%,
which was lower than 4.44% in the control group, however there was no statistical significance (P>0.05).
Conclusion: Compared with dexmedetomidine, the combination of dexmedetomidine and midazolam can ensure
the safety of anesthesia and better anesthetic efficacy. However, the early stage heart rate during anesthesia is
obviously decreased, thus the hemodynamics monitoring is important.

Published
2019-09-15